Healthcare Provider Details

I. General information

NPI: 1861869752
Provider Name (Legal Business Name): HEATHER E. DEEL APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2015
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N MAIN ST
STANTON KY
40380-2174
US

IV. Provider business mailing address

101 N MAIN ST
STANTON KY
40380-2174
US

V. Phone/Fax

Practice location:
  • Phone: 606-775-0515
  • Fax: 606-552-0964
Mailing address:
  • Phone: 606-775-0515
  • Fax: 606-552-0964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3009709
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: